Aneurin Bevan may have been the architect of the NHS, but the inspiration for enduring state-funded healthcare was the Tredegar Medical Aid Society, as Irena Morgan explains.

ANEURIN BEVAN was ultimately responsible for the establishing the NHS in 1948. But the Tredegar politician and MP for Ebbw Vale, who became Minister for Health and Housing in 1945, had an ideal model on which to base his new health service, which has been described as “the most far-reaching piece of social legislation in British history”.

That model was the local community self-help scheme run by the Tredegar Workmen’s Medical Aid Society on which Bevan had served as a committee member in the 1920s.

When he created the NHS, Bevan said, “All I am doing is extending to the entire population of Britain the benefits we had in Tredegar for a generation or more. We are going to ‘Tredegar-ise’ you.”

And as former Labour leader Neil Kinnock later wrote, in the forward to Dr Gareth Jones’s book, The Aneurin Bevan Inheritance, “The mixture of cunning and passion that he [Bevan] had to employ in establishing the NHS is widely recognised.

“Less attention has been given to the way in which he learned the arts and crafts of providing and managing communal health care in the Tredegar Workmen’s Medical Aid Society.

“But, as he testified, the experience of a local working model that embodied all the principles of universal donation during fitness for universal provision during illness was invaluable. It made the rapid establishment of a national system feasible because that task was then more a matter of refinement and enlargement rather than one of raw invention.”

The Tredegar Medical Aid Society was formed around 1890 and was widely regarded as one of the best of its kind. Under this local health service, almost all of the town’s residents were covered by the scheme through subscriptions which entitled members and their dependants to the most comprehensive and the best medical, surgical and dental services in the country, according to need and free at point of care.

The plaque outside 10 The Circle, in Tredegar, reads, “These were the offices of a mutual society (1890) formed by miners and ironworkers of the Tredegar Iron and Coal Co.

“Through modest weekly contributions, they were able to employ doctors, a surgeon and run a hospital. Bevan’s political influence locally enabled socialist working-class nominees to gain control.”

Tredegar’s Medical Aid Society had emerged from the Health and Education Fund established in the town around 1871. This had been set up with representatives of workers and the management of the Tredegar iron and coal companies, which later merged. The society was one of a number of community health schemes set up during the 19th century, especially in the industrialised South Wales valleys.

They were initially a means of treating victims of work-related accidents and combating diseases such as typhoid, tuberculosis and cholera.

Under these medical aid and health fund schemes, each worker employed in the ironworks and collieries paid 3d in the pound from their wages to receive medical care for themselves and their families.

Part of the fund financed sick pay at different rates for men, women and boys for a period of 12 months. Other people who were not directly employed by the Tredegar Iron and Coal Company could subscribe to the society and enjoy the same benefits with the exception of sick pay. This early fund also helped to maintain schools in the area.

In around 1890, the company scheme merged with others developed independently by benevolent societies in the town and all their funds were combined.

The new society became known as Tredegar Workmen’s Medical Aid and Sick Relief Fund, and eventually had a membership of nearly 5,000.

Tredegar General Hospital was opened in December, 1904 – the initiative came from the Medical Aid Society.

Land for the new Tredegar Park Cottage Hospital – as it was then called – was donated by Lord Tredegar, who also gave Bedwellty Park to the town’s people.

Funding came from the Tredegar Iron and Coal Company, other local employers and organisations, donations from individuals, public donations and above all from men employed in the pits who agreed to maintain the hospital by having an extra halfpenny a week deducted from their wages – in 1909 it rose to an additional 1d per week.

Bevan was a member of the cottage hospital’s management committee around 1928 and became chairman in 1929/30.

Between 1915 and the birth of the NHS, the society employed a team of five doctors, two dentists, two dental mechanics, three dispensers and their assistants and a nurse.

Members, their dependants – plus retired members and widows – also received free spectacles, drugs, and any appliances they might have needed. If a referral was needed, they could receive free treatment, said to be within days, at hospitals outside the Tredegar area. Fares for buses or trains were paid for or transport provided.

When the NHS was launched in 1948, the new Ministry of Health took over most of the facilities and staff provided by the Medical Aid Society and the hospital committee. Members, however, decided that the society should carry on in a modified way – it was eventually wound up in 1995.

More information about the medical aid society is available from the Tredegar Development Trust’s website www.cradleofnhs.org.uk

Page 2 - Edna Adams on life before the welfare state

Edna Adams’s first child was born at the same time as the NHS. Here the retired nurse and teacher from Cowbridge explains what life was like growing up before the welfare state...

My first baby was due to arrive in July 1948. I had booked a bed at St David’s Hospital in Cardiff – and paid four guineas for the privilege.

Prior to July 5 – the first day of the welfare state – I do not remember that we had been well informed of this great turning point in our lives, although we would not have been subjected to a massive media campaign, like today.

We had no electricity, the radio was powered by an accumulator battery, which had to be taken to Cowbridge for topping up. Newspapers were not delivered and only later were we able to afford to have the Western Mail by post daily.

Although my baby was due on July 3, I still had to pay the full bed fee and to purchase my own maternity pads and other items.

I was admitted to hospital on June 30 with toxemia and the baby was born on July 11 – I remained at St David’s for a further 14 days.

Because the baby was born after July 5 – the day the free health service was born – the pads and other items were returned to me in full. Later, after returning home, I received a cheque for about £3 as a reimbursement of the fees I’d paid. About a month after the birth I also received a maternity allowance of £8. Family allowance was also available, but not for a first child.

The irony of this story is that if I had consulted the hospital almoner at the booking clinic, I would have received my bed and maternity care free of charge.

Our wages at that time – my husband was employed in a forest nursery and earned £3 10s – were compatible with parish relief.

At the time of my birth in 1928, my parents would have been in receipt of parish relief, via the board of guardians, which would have met the cost of my birth at Glossop Terrace, the maternity wing of Cardiff Royal Infirmary.

From my birth until long after I left school, I was part of the “indoor and outdoor” relief system.

Sometime in 1926 my father had suffered an accident on board a ship in Cardiff Docks. Until the time of his accident he had held good positions and earned a fair income working as a tallyman. There was also a further income from a small millinery business, which was run by mother in City Road, Cardiff.

There was no compensation following the accident and the shop was losing money during a time of employment unrest. By the time of my birth, my parents were subject to bankruptcy and the loss of all household possessions.

From the time of my father’s accident and the loss of the business, as a family we were totally reliant on public assistance of £2 7s and a sum of 7/6 (37½p) sick benefit was paid weekly by my father’s Friendly Society.

With an entitlement to parish financial relief came an open door policy to many other provisions, the first of which was medical aid.

We had a family doctor – a parish panel and private doctor – and my younger brother and I went through the usual childhood ailments. A visit from the doctor was only to confirm that our ailment was not a reportable illness, such as scarlet fever or diphtheria.

There was little or no medication available for petty ailments, although quarantine was strictly enforced and serious cases were hospitalised at the City Isolation Hospital.

If we were prescribed medicine, this meant a trip to the parish dispensary in Charles Street – here my mother collected large jars of cod liver oil and malt.

I developed TB glands in the neck and was prescribed a black, tar-like, evil-smelling poultice, which was spread on lint and applied to the many swellings on my neck. It was to take many years for the last swollen gland to subside.

In the absence of all the wonderful drugs which are available today – specifically antibiotics and steroid preparations – I wonder how we survived.

I suffered from earaches and sore throats and there was little available for either complaint. Bright yellow sulphur powder was put on a square of paper, placed to my open mouth and blown to the back of my throat – I hated this procedure.

Apart from olive oil, earache could be helped with a herbal remedy of my grandmother’s.

My paternal grandmother had been a noted healer and herbalist and my father still followed many of her principles and remedies. After her death, my father’s sister continued to make up favourite ointments, which were always used to heal our many cuts and scrapes.

If we had hurt ourselves and needed sutures or injured our bones, we went to the City Lodge outpatients department for treatment.

My father was a regular inpatient, suffering from a severe stomach complaint. Llandough Hospital was opened in 1933 as a poor law hospital to take the overflow of medial patients from City Lodge – my father was one of its first patients. I remember going to visit him, but I had to stay outside.

Such was the success of Llandough for the poor of Cardiff that it was unable to take paying patients from Penarth, causing comment in the Penarth Times.

In about 1943 my mother became very ill with pleurisy and, apart from my younger brother, I was alone to nurse her. The doctor left a prescription for the new wonder drug sulphonimide – which, I understand, was given to Churchill when he had pneumonia – and a tin of kaolin poultice.

This paste was heated in a tin of boiling water and the resulting warm poultice was spread on a piece of lint and applied to the area of the affected lung – often I made it too hot.

In 1945, at the age of 15, my brother was admitted to St David’s Hospital – the new name for City Lodge – with rheumatic fever. He was very ill and not expected to live, but he stabilised and was moved first to Llandough Hospital and later to the chest hospital in Sully.

He was to undergo open chest surgery at Sully, performed by a London surgeon. We knew it was a dangerous operation, but how dangerous, we were not told.

My brother had developed pericarditis, following the rheumatic fever. His condition had been described to us as “like an apron of dense adhesions” around the heart, constricting it and preventing it from functioning properly.

Until this time pericarditis was a life-threatening and inoperable condition. My brother underwent pioneering surgery, which entailed opening his chest and, as he held my brother’s beating heart in his hand, the surgeon was able to clean the “apron” from the organ, releasing the constrictive force.

All the nursing and medical care in the three hospitals for at least 15 months was met by public assistance. A bill from the London surgeon for 125 guineas came to my father, who simply passed it to the relieving officer for payment.

We also had access to medical equipment, such as glasses, dentures, hearing aids, special footwear and artificial appliances. These were referred to as “relief beyond scale” and were always subject to application and scrutiny by the relieving officer.

School children were subject to regular medical screening at school, including eyes, ears and teeth. Physical examination was done by the medical officer and there were also regular inspections for head lice – these could include home visits as well.

These regular health inspections were important to the welfare of children from every walk of life. Malnutrition was not always the prerogative of poor families. Children under school age were notified to attend welfare clinics, which were held in all districts and failure to attend was a reportable offence.

In some respects, July 1948 and the arrival of the welfare state and a free health service made little or no difference to many people, especially the elderly and disabled.

They visited the same doctor, were treated at the same hospitals and received the same public financial assistance and sickness benefit.

Today, my father would be in receipt of pension and income support – he would not have feared the workhouse but, like many elderly today, would have fought tooth and nail to keep clear of the sad, debilitating community homes of today.

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